Qualitative study of the lived experience of mental illness

288 Pages·2017·1.58 MB·English

Edith Cowan University
Research Online
Theses: Doctorates and Masters Theses
2014
Learning from the experts: Qualitative study of the lived
experience of mental illness
Zdenka Bartova
Edith Cowan University
Follow this and additional works at: https://ro.ecu.edu.au/theses
Part of the Mental and Social Health Commons, and the Psychology Commons
Recommended Citation
Bartova, Z. (2014). Learning from the experts: Qualitative study of the lived experience of mental illness.
https://ro.ecu.edu.au/theses/1412
This Thesis is posted at Research Online.
https://ro.ecu.edu.au/theses/1412
Edith Cowan University
Research Online
Teses: Doctorates and Masters Teses
2014
Learning from the experts: Qualitative study of the
lived experience of mental illness
Zdenka Bartova
Edith Cowan University
Recommended Citation
Bartova, Z. (2014). Learning fom the experts: Qualitative study of the lived experience of mental illness. Retrieved from
htp://ro.ecu.edu.au/theses/1412
Tis Tesis is posted at Research Online.
htp://ro.ecu.edu.au/theses/1412
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USE OF THESIS

The Use of Thesis statement is not included in this version of the thesis.
Learning from the Experts: Qualitative Study of the Lived Experience of Mental Illness
By
Zdenka Bartova, B. A. (Hons)

A thesis submitted in fulfilment of the requirements for the award of the degree

Doctor of Philosophy

School of Psychology and Social Science
Faculty of Health, Engineering and Science
Edith Cowan University

October 2014
Abstract
Severe mental illness has a profound effect on the affected individuals yet it does not
necessarily prevent them from leading a meaningful and fulfilling life, and therefore
recovering. Recovery has received a great interest in clinical and consumer research yet
little is known about how those individuals who do not primarily identify with recovery
respond to the concept and come to accept it as something that is personally meaningful.
Using a qualitative approach following the principles of Gadamer’s (1975)
hermeneutics, the present study explored people’s subjective experience of mental
illness with the aim of identifying factors related to their views of mental illness, their
adaptation, coping and recovery, and the subjective meanings they gave to the
phenomenon.
In Phase I, 25 adults diagnosed with mental illness participated in unstructured,
confidential interviews at the end of which they completed the Recovery Assessment
Scale-Revised (RAS-R) (Corrigan et al., 1999). The study identified six main themes
related to person-centred and social/relational factors that played a role in the persons’
life with mental illness: (a) mental illness as a journey, (b) personal conceptualisations
of mental illness, (c) illness management and coping, (d) losses and gains, (e)
professional help, and (f) the role of others.
Phase II was completed by 18 participants from the original sample who were provided
with feedback on their respective RAS-R (Corrigan et al., 1999) results and who in turn
provided their feedback on the scale and their experience of completing it; this was
followed by a discussion of recovery. The participant narratives suggested that recovery
was conceptualised in two broad ways: as a return to baseline following crisis and as
living as best as one can given personal circumstances. The findings further indicated
that recovery as a concept had the potential to remain abstract and lack in meaning
unless the person’s biases and perceptions were explored in an opened, non-directive
conversation.
Both the initial interview and the follow-up session were audiotaped, transcribed and
consequently subjected to thematic content analysis. Following the analysis, the
participants were invited for a third interview during which they were asked to provide
feedback on the analysis and add further information. This represented Phase III, which
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was completed by 10 participants from the original sample; this phase also served as a
reflection on the experience of research participation. Findings indicated that research
participation was generally seen as a positive experience that could have potentially
therapeutic benefits. The process involved active engagement for both the participants
and the researcher, which may have helped foster closeness but that also raised a
number of ethical dilemmas, primarily in terms of dual roles and researcher self-
disclosure.
Overall, the studies highlighted the complex interplay of both clinical and non-clinical
factors that the individuals took into account as they were making sense of their
experience. The studies have a number of clinical implications, specifically addressing
the role of hospitals in treatment, the relationship between mental illness and trauma,
participatory assessment of recovery, and the role of clinical psychology in the
treatment of severe mental illness. Furthermore, the studies point out the potential
benefits of supplementing clinical work, whether in research or in treatment, with the
methods and processes of Gadamerian hermeneutics.
The core principles of the Gadamerian approach (the fusion of the horizons of meaning,
the hermeneutic circle and the dialogue) promote viewing of a phenomenon as a
contextually embedded experience that is interpreted through the person’s pre-existing
views and his/her present range of vision. The approach conceptualises interactions
between two parties as opened conversations that aim at shared understanding, rather
than objective truth. Such conversations are characterised by a back-and-forth
movement between the whole and its parts, which eventually leads to improved
understanding. Therefore greater appreciation of contextual information and meaning-
making processes; treating both sources of expertise (consumer and professional) as
equally important; viewing psychopathology as only one part of mental illness and
mental illness as one part of the person’s life; and finally approaching clinical and
research interactions as relational endeavours that test the underlying assumptions of
both parties could help influence the way mental health professionals work with
individuals with severe mental illness.

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Declaration
I certify that this thesis does not, to the best of my knowledge and belief:
i. incorporate without acknowledgment any material previously submitted for a
degree or diploma in any institution of higher education;
ii. contain any material previously published or written by another person except
where due reference is made in the text of this thesis; or
iii. contain any defamatory material.

iv
Acknowledgment
My biggest thanks and gratitude go to the men and women who took their time to
participate in my research and generously share their stories. Their courage and
willingness to open up has left me determined to do my best as a person and as a
professional. I would also like to thank the staff and members of the Lorikeet and June
O’Connor centres for their discussions and for always making me feel welcome.
Next, I want to thank my supervisor, Dr. Ken Robinson, for his help, encouragement
and mentorship. Great thanks to Rachel French for helping me improve my writing, and
to my critical reader, Dr Jennifer Loh, for her valuable feedback.
Finally, I would never have been able to complete this project without the love and
support from my family and friends. Special thanks go to Phill, for his patience and for
always believing in me, and to my boys, William and Samuel, for keeping things in
perspective and for reminding me that there is life outside the PhD.

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TABLE OF CONTENTS

Abstract ................................................................................................................................... ii
Declaration ............................................................................................................................. iv
Acknowledgment .................................................................................................................... v

CHAPTER 1
Introduction and overview of the thesis ............................................................................... 1

CHAPTER 2
Literature review .................................................................................................................. 10
Recovery ................................................................................................................................. 12
Definition and conceptualization ....................................................................................... 13
How people recover ............................................................................................................ 17
Assessing recovery ............................................................................................................. 20
Recovery-oriented care ....................................................................................................... 24
Recovery-oriented interventions and programs. ............................................................. 25
Recovery-oriented treatment. ......................................................................................... 26
System transformation. ................................................................................................... 28
Summary and rationale for the present studies ....................................................................... 29

CHAPTER 3
Method ................................................................................................................................... 34
Design ................................................................................................................................. 34
Overview ............................................................................................................................ 38
Pilot study: Case studies. ................................................................................................ 38
Phase I: Exploration of the lived experience of people diagnosed with mental illness .. 39
Phase II: Feedback on the Recovery Assessment Scale and exploration of recovery. ... 40
Phase III: Follow-up interview. ...................................................................................... 41
Sample ................................................................................................................................ 42
Procedure ............................................................................................................................ 44
Establishing trustworthiness ............................................................................................... 46
Ethics .................................................................................................................................. 46
Analysis 47

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